文章摘要

血清脂氧素A4、中性粒细胞明胶酶相关脂质运载蛋白、降钙素原在急性胰腺炎患者中的变化及意义

作者: 1胡丹凤, 2皮莉芳, 2胡汉楚, 1秦兰
1 黄冈市中医医院老年病科,湖北 黄冈 438000
2 黄冈市中医医院内科,湖北 黄冈 438000
通讯: 胡丹凤 Email: yiyuan958@yeah.net
DOI: 10.3978/j.issn.2095-6959.2019.12.010

摘要

目的:分析血清脂氧素A4(lipoxide A4,LXA4)、中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-related lipid carrier protein,NGAL)、降钙素原(procalcitonin,PCT)在急性胰腺炎(acute pancreatitis,AP)患者中的变化及意义。方法:95例AP患者根据病情程度分为轻型急性胰腺炎(mild acute pancreatitis,MAP)组(57例)及重型急性胰腺炎(severe acute pancreatitis,SAP)组(38例),按照住院期间临床转归情况分为存活组(77例)与死亡组(18例),同期选择76例门诊健康体检者作为对照组。比较各组血清LXA4,NGAL,PCT水平,分析以上指标对AP患者预后的预测价值。结果:AP组第1,3,7天血清LXA4低于对照组,NGAL及PCT水平高于对照组(P<0.05)。MAP组血清LXA4水平高于SAP组,血清NGAL及PCT水平低于SAP组(P<0.05);MAP组及SAP组入院后第3,7天,血清LXA4水平逐渐上升,血清NGAL及PCT水平逐渐下降(P<0.05)。入院第1天,存活组血清LXA4水平高于死亡组,血清NGAL及PCT水平低于死亡组(P<0.05)。LXA4预测AP患者预后的受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under the curve,AUC)为0.755,NGAL为0.830,PCT为0.864,LXA4+NGAL+PCT为0.944,LXA4+NGAL+PCT预测的AUC高于单个指标。结论:血清LXA4,NGAL及PCT能够有效反映AP的病情程度和预后情况,为此类患者的临床个体化治疗提供依据。
关键词: 急性胰腺炎;脂氧素A4;中性粒细胞明胶酶相关脂质运载蛋白;降钙素原

Changes of serum lipoxide A4, neutrophil gelatinase-related lipid carrier protein and procalcitonin in patients with acute pancreatitis and their significance

Authors: 1HU Danfeng, 2PI Lifang, 2HU Hanchu, 1QIN Lan
1 Department of Geriatric, Huanggang Traditional Chinese Medicine Hospital, Huanggang Hubei 438000, China
2 Department of Internal Medicine, Huanggang Traditional Chinese Medicine Hospital, Huanggang Hubei 438000, China

CorrespondingAuthor: HU Danfeng Email: yiyuan958@yeah.net

DOI: 10.3978/j.issn.2095-6959.2019.12.010

Abstract

Objective: To analyze the changes and significance of serum lipoxide A4 (LXA4), neutrophil gelatinase-related lipid carrier protein (NGAL) and procalcitonin (PCT) in patients with acute pancreatitis (AP). Methods: A total of 95 AP patients were divided into 57 cases of mild acute pancreatitis (MAP) group and 38 cases of severe acute pancreatitis (SAP) group according to the disease degree, according to the hospital clinical outcome were divided into a survival group (77 cases) and a death group (18 cases); at the same time, we chose 76 cases of outpatient health physical examination as a control group. Serum levels of LXA4, NGAL and PCT of each group were compared, to analyze the prognostic value of the above indicators for AP patients. Results: Serum level of LXA4 in AP group was lower than that in control group on day 1, 3 and 7, and levels of NGAL and PCT were higher than those in control group (P<0.05). Serum level of LXA4 in MAP group was higher than that in SAP group, and serum levels of NGAL and PCT were lower than those in SAP group (P<0.05). Serum level of LXA4 gradually increased and serum levels of NGAL and PCT gradually decreased in the MAP group and SAP group on day 3 and 7 after admission (P<0.05). On the first day of admission, serum level of LXA4 in the survival group was higher than that in the death group, and serum levels of NGAL and PCT were lower than that in the death group (P<0.05). The area under the receiver operating characteristic (ROC) curve predicted by LXA4 for the prognosis of AP patients was 0.755, NGAL was 0.830, PCT was 0.864, LXA4+NGAL+PCT was 0.944, and the area under the curve (AUC) predicted by LXA4+NGAL+PCT was higher than the single index. Conclusion: Serum LXA4, NGAL and PCT can effectively reflect the disease status and prognosis of AP, and provide a basis for clinical individualized treatment of such patients.
Keywords: acute pancreatitis; lipoxide A4; neutrophil gelatinase-related lipid carrier protein; calcitonin original